Li Huijie, Deng Yueyi, Huang Yitong, Blake Holly
Department of Nephrology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
School of Media and Communication, Shanghai Jiaotong University, Shanghai, China.
PLoS One. 2025 Mar 18;20(3):e0320340. doi: 10.1371/journal.pone.0320340. eCollection 2025.
Psychological determinants underlying the dietary management intention (DMI) of Chinese patients with chronic kidney disease (CKD) are not well understood. This hinders the development of theory-informed dietary interventions targeting this population. The aim of this study was to identify factors influencing DMI of Chinese patients with CKD through the lens of Protection Motivation Theory (PMT).
500 patients with CKD from a nephrology ward of a large teaching hospital in China completed a survey including measures of PMT constructs (i.e., perceived vulnerability, perceived severity, intrinsic and extrinsic rewards, self-efficacy, response efficacy, and response cost) using validated scales adapted from previous studies. Data were analyzed using confirmatory factor analysis and multiple linear regression.
Three PMT constructs, namely perceived severity [B = 0.198, P < 0.001], response efficacy [B = 0.331, P < 0.001], and self-efficacy [B = 0.325, P < 0.001], two demographic variables, namely single status [B = -0.180, P = 0.028] and education level [B = 0.080, P = 0.007], and a disease-related variable, namely CKD stage [B = .056, P = 0.001], predicted 39.3% of the variance of the CKD DMI. No significant effect on CKD DMI was observed for other predictor variables (P > 0.05).
Applying the PMT, significant predictors of DMI in Chinese patients with CKD were identified, which should be targeted in behavior change initiatives aimed at promoting dietary management.
中国慢性肾脏病(CKD)患者饮食管理意图(DMI)背后的心理决定因素尚未得到充分理解。这阻碍了针对该人群的基于理论的饮食干预措施的发展。本研究的目的是通过保护动机理论(PMT)的视角,识别影响中国CKD患者DMI的因素。
来自中国一家大型教学医院肾内科病房的500名CKD患者完成了一项调查,该调查使用了根据先前研究改编的经过验证的量表,测量了PMT的构成要素(即感知易感性、感知严重性、内在和外在奖励、自我效能感、反应效能感和反应成本)。使用验证性因素分析和多元线性回归对数据进行分析。
三个PMT构成要素,即感知严重性[B = 0.198,P < 0.001]、反应效能感[B = 0.331,P < 0.001]和自我效能感[B = 0.325,P < 0.001],两个人口统计学变量,即单身状态[B = -0.180,P = 0.028]和教育水平[B = 0.080,P = 0.007],以及一个疾病相关变量,即CKD分期[B = 0.056,P = 0.001],预测了CKD DMI方差的39.3%。未观察到其他预测变量对CKD DMI有显著影响(P > 0.05)。
应用PMT,确定了中国CKD患者DMI的重要预测因素,这些因素应在旨在促进饮食管理的行为改变倡议中作为目标。